A review of the UNICEF roll-out of the CLTS approach in West and Central Africa

The Community Led Total Sanitation approach has been introduced by UNICEF in 19 of the 24 countries of both Francophone and Anglophone West and Central Africa since 2008. This paper marks the gradual end of the pilots and the start of a more developmental and scaling up phase. The review assesses the progress of CLTS in the region and considers improvements for scaling up. CLTS has been found to be largely well accepted, and over 2,000 communities had become open defecation free (ODF) by the end of 2010, meaning that close to a million people in the region are benefitting from ODF environments and associated health benefits after just 2 years. If the gains continue to progress at the same rate, CLTS has the potential to bring many of the region’s countries on target for the sanitation goals of 2015 (MDG 7). Recommendations and challenges that have emerged are discussed with the intention of promoting the lessons learnt from the pilot phase and scaling up in an equitable and sustainable manner.